R-spondin 1/Dickkopf-1/beta-catenin machinery is involved in testicular embryonic angiogenesis

Testicular vasculogenesis is one of the key processes regulating male gonad morphogenesis. The knowledge of the molecular cues underlining this phenomenon is one of today's most challenging issues and could represent a major contribution toward a better understanding of the onset of testicular morphogenetic disorders. R-spondin 1 has been clearly established as a candidate for mammalian ovary determination. Conversely, very little information is available on the expression and role of R-spondin 1 during testicular morphogenesis. This study aims to clarify the distribution pattern of R-spondin 1 and other partners of its machinery during the entire period of testicular morphogenesis and to indicate the role of this system in testicular development. Our whole mount immunofluorescence results clearly demonstrate that R-spondin 1 is always detectable in the testicular coelomic partition, where testicular vasculature is organized, while Dickkopf-1 is never detectable in this area. Moreover, organ culture experiments of embryonic male UGRs demonstrated that Dickkopf-1 acted as an inhibitor of testis vasculature formation. Consistent with this observation, real-time PCR analyses demonstrated that DKK1 is able to slightly but significantly decrease the expression level of the endothelial marker Pecam1. The latter experiments allowed us to observe that DKK1 administration also perturbs the expression level of the Pdgf-b chain, which is consistent with some authors' observations relating this factor with prenatal testicular patterning and angiogenesis. Interestingly, the DKK1 induced inhibition of testicular angiogenesis was rescued by the co-administration of R-spondin 1. In addition, R-spondin 1 alone was sufficient to enhance, in culture, testicular angiogenesis

Risk perception and affective state on work exhaustion in obstetrics during the COVID-19 pandemic

Amulticenter cross-sectional survey study involving four Italian University Hospitals was performed to test the hypothesis that negative affect and positive affect (affective dimensions) mediate the association between risk perception (perceived risk of infection and death; cognitive dimensions) and the feeling of work exhaustion (WE) among obstetrics healthcare providers (HCPs) during the Coronavirus Disease 2019 (COVID-19) pandemic. Totally, 570 obstetrics HCPs were invited to complete the 104-item IPSICO survey in May 2020. A theoretical model built on the tested hypothesis was investigated by structural equation modelling. The model explained 32.2% of the WE variance. Only negative affect mediated the association between cognitive dimensions and WE and also the association between WE and psychological well-being before the pandemic, experiences of stressful events, female gender, and dysfunctional coping. Non-mediated associations withWE were observed for work perceived as a duty, experience of stressful events, support received by colleagues, and the shift strategy. Only previous psychological well-being, support by colleagues, and shift strategies were inversely associated with WE. Based on study results, monitoring negative than positive affect appears superior in predicting WE, with practical implications for planning psychological interventions in HCPs at the individual, interpersonal, and organizational levels

Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0–2 weeks, 3–4 weeks and 5–6 weeks of the diagnosis (odds ratio (95%CI) 4.1% (3.3–4.8), 3.9% (2.6–5.1) and 3.6% (2.0–5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5% (0.9– 2.1%)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2–8.7) vs. 2.4% (95%CI 1.4–3.4) vs. 1.3% (95%CI 0.6–2.0%), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay

PTEN and Gynecological Cancers

PTEN is a tumour suppressor gene, and its loss of function is frequently observed in both heritable and sporadic cancers. It is involved in a great variety of biological processes, including maintenance of genomic stability, cell survival, migration, proliferation and metabolism. A better understanding of PTEN activity and regulation has therefore emerged as a subject of primary interest in cancer research. Gynaecological cancers are variously interested by PTEN deregulation and many perspective in terms of additional prognostic information and new therapeutic approaches can be explored. Here, we present the most significant findings on PTEN in gynaecological cancers (ovarian, endometrial, cervical, vulvar and uterine cancer) focusing on PTEN alterations incidence, biological role and clinical implications

Pleurostomophora richardsiae associated with trunk diseases of grapevines in southern Italy

Pleurostomophora richardsiae (Nannf. apud Melin & Nannf.) L. Mostert, W. Gams & Crous was previously known mainly as a human pathogen. However, more recently this fungus has been isolated from wood tissue of grapevines that show Petri and esca disease symptoms in California (USA) and South Africa. During an assessment carried out in southern Italy, the abundant presence of this fungus was demonstrated by morphological, cultural and molecular means. Pleurostomophora richardsiae was isolated from sub-cortical wood patches and streaking of trunks and cordons of grapevine cultivars that showed decline and dieback symptoms. To understand its putative pathogenic role, pathogenicity tests were conducted in greenhouse experiments, where young grapevine plants of two cultivars were artificially inoculated with two isolates each of Pl. richardsiae, Lasiodiplodia theobromae and Phaeoacremonium aleophilum. Within 130 d, all three fungi produced brown streaking in both grapevine cultivars. The L. theobromae and Pl. richardsiae isolates were the most aggressive. Although the Pm. aleophilum isolates were pathogenic, they induced less severe wood streaking than the other two fungi. Therefore, Pl. richardsiae is considered a fungal pathogen of grapevine. All three fungal species were re-isolated from discolored tissue of all inoculated shoots, thus fulfilling Koch’s postulates

Pleurostomophora richardsiae associated with trunk diseases of grapevines in southern Italy

Pleurostomophora richardsiae (Nannf. apud Melin & Nannf.) L. Mostert, W. Gams & Crous was previously known mainly as a human pathogen. However, more recently this fungus has been isolated from wood tissue of grapevines that show Petri and esca disease symptoms in California (USA) and South Africa. During an assessment carried out in southern Italy, the abundant presence of this fungus was demonstrated by morphological, cultural and molecular means. Pleurostomophora richardsiae was isolated from sub-cortical wood patches and streaking of trunks and cordons of grapevine cultivars that showed decline and dieback symptoms. To understand its putative pathogenic role, pathogenicity tests were conducted in greenhouse experiments, where young grapevine plants of two cultivars were artificially inoculated with two isolates each of Pl. richardsiae, Lasiodiplodia theobromae and Phaeoacremonium aleophilum. Within 130 d, all three fungi produced brown streaking in both grapevine cultivars. The L. theobromae and Pl. richardsiae isolates were the most aggressive. Although the Pm. aleophilum isolates were pathogenic, they induced less severe wood streaking than the other two fungi. Therefore, Pl. richardsiae is considered a fungal pathogen of grapevine. All three fungal species were re-isolated from discolored tissue of all inoculated shoots, thus fulfilling Koch’s postulates

De-intensification of basal-bolus insulin regimen after initiation of a GLP-1 RA improves glycaemic control and promotes weight loss in subjects with type 2 diabetes

Aims To evaluate the impact of adding a glucagon-like peptide-1 receptor agonist (GLP-1 RA) in people with type 2 diabetes (T2D) in basal-bolus (BB) insulin regimen, on insulin requirement, HbA1c, weight loss up to 24 months. Methods Data on subjects with T2D on BB who initiated a GLP-1 RA have been retrospectively collected. HbA1c, body weight, and insulin dose were recorded at baseline, 6, 12, and 24 months after initiation of GLP-1 RA therapy. A linear mixed model for repeated measures was used to evaluate the changes in HbA1c, body weight, and insulin requirement over time. Results We included 156 subjects (63.5% males; age 62 +/- 11 years, HbA1c 70 +/- 22.0 mmol/mol; 8.6 +/- 4.2%). Compared to baseline, HbA1c and body weight were significantly lower at 6 months after introducing a GLP-1RA and remained stable up to 24 months (all p < 0.0001 vs. baseline). At 24 months, 81% of subjects discontinued prandial insulin, while 38.6% discontinued basal insulin as well. Insulin requirement at baseline (aOR 0.144; 95% CI, 0.046-0.456; P = 0.001) was the only significant predictor of prandial insulin discontinuation. Conclusions Replacing prandial insulin with GLP-1 RA is a valuable strategy to simplify the BB insulin regimen while improving glycaemic control and promoting weight loss in subjects with T2D

Amoebic colitis and liver abscess: A rare case of autochthonous invasive infection due to Entamoeba histolytica

We report an unusual and confirmed case of invasive amebiasis in a non-endemic area where the source of infection remains unknown. During her admission, the patient developed amebic colitis and extraintestinal liver abscess with a favorable outcome following the antiparasitic therapy

Ultrasound, macroscopic and histological features of malignant ovarian tumors

Ultrasound examination is considered to be the first line imaging method to diagnose an ovarian mass with a high degree of accuracy, discriminating between benign and malignant ovarian masses in the hands of experienced examiners. The International Ovarian Tumor Analysis (IOTA) group provided a standardized terminology of ovarian masses1 and suggested simple ultrasound rules that can be used to classify adnexal masses as benign or malignant.2 The IOTA group has also created logistic regression models (ie, ADNEX (Assessment of Different NEoplasias in the adneXa) model), including clinical and ultrasound information to calculate the likelihood of malignancy in adnexal masses. The IOTA ADNEX model estimates the likelihood not only of an adnexal mass being benign or malignant but also the likelihood that the mass is benign, borderline malignant, stage I primary invasive malignant, stage IIIV primary invasive malignant or a metastasis in the ovary from another primary tumor. 3 Recently, a consensus meeting including European and North American professionals developed a new risk model for the pre-operative assessment of adnexal masses, called O-RADS (Ovarian-Adnexal Reporting and Data System). The O-RADS ultrasound risk stratification and management system was designed to provide consistent interpretations, to decrease or eliminate ambiguity in ultrasound reports resulting in a higher probability of accuracy in assigning risk of malignancy to ovarian and other adnexal masses, and to provide a management recommendation for each risk category. 4 Moreover, during the past 15 years authors of the IOTA group have described the typical ultrasound appearance of several different adnexal pathologies, including various histotypes of malignancy, collected in the series of Imaging in gynecology papers. 510 Indeed, ovarian cancer includes several histological entities which can be grouped into four histological groups: epithelial tumors, germ cell tumors, stromal tumors and metastatic tumors. Each histopathological category is often characterized by some morphological typical features, as described in the textbooks of pathologists. In the pre-operative phase, ultrasound examination can enable assessment of these macroscopic aspects, thus providing a presumptive histological diagnosis. We present a video describing how to apply the simple ultrasound rules, the IOTA ADNEX model and the O-RADS model, and provides explanatory examples for each model

Evaluation of Fungal Growth on Olive-Mill Wastewaters Treated at High Temperature and by High-Pressure Homogenization

Reuse of olive mill wastewaters (OMWWs) in agriculture represents a significant challenge for health and safety of our planet. Phytotoxic compounds in OMWW generally prohibit use of untreated OMWWs for agricultural irrigation or direct discharge into surface waters. However, pretreated OMWW can have positive effects on chemical and microbiological soil characteristics, to fight against fungal soil-borne pathogens. Low amounts of OMWW following thermal (TT-OMWW) and high-pressure homogenization (HPH-OMWW) pretreatments counteracted growth of some of 12 soil-borne and/or pathogenic fungi examined. With fungal growth measured as standardized change in time to half maximum colony diameter, Δτ, overall, HPH-OMWW showed increased bioactivity, as increased mean Δτ from 3.0 to 4.8 days. Principal component analysis highlighted two fungal groups: Colletotrichum gloeosporioides, Alternaria alternata, Sclerotium rolfsii, and Rosellinia necatrix, with growth strongly inhibited by the treated OMWWs; and Aspergillus ochraceus and Phaeoacremonium parasiticum, with stimulated growth by the treated OMWWs. As a non-thermal treatment, HPH-OMWW generally shows improved positive effects, which potentially arise from preservation of the phenols